WQ0036327_Monitoring - 11-2016_20161219

FORM: NDAR-2 0&11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page 1 of 2
Perri W00036327
Facility Name: Mystic Meadows VVWTF
County: Swain Month:
November Year: 2016
Did
Infiltration occur at
Site Name;
I
this facility?
,j a ne i,
A
Are,
roe (acres):
Pi I— . ,
q:�,%Wrea(wres): 11614iL
Area (acini
0 YES [M NO
Rate (GP.Dtfl3)i.�__210 1,
Rate (
Rate (GPDMt'):
Oil,
Rate (GPDIW):
eatheIr Freeboard
4', 'a, ihfl rits I Ej�,i`S'4t� `046
SiteIn
Site Infiltrated? yEs
❑ No
Site Infiltrated? E]YEs ONO
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FORM: NDAR-2 08.11
NON -DISCHARGE APPLICATION REPORT (NDAR-2)
Did the application rates exceed the limits in Attachment B of your perm@?
If not a basin, were the sites kept free of vegetation and raked?
If not a basin, were there any Instances of effluent ponding In or runoff from the sites?
If a basin, were there any Instances of breakout from the berms?
Was the onsite automatically activated standby power source tested and operational?
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If the facility Is non-compliant, please Wisin In the apace below the reason(s) the Willy was not In compliance. Provide In your explanation the date(&) of the rion-amp8ancs and dpWM the carodM
action(s) taken. Attach additional sheete 9 necessary.
Operator in Responsible Charge (ORC) Certification
PermNW Certification
OFIC: Michael Bolt
Permittee: Meadow Partnere
Certification No.: 229W
Sgrdng OfflclW: Hugh Shannon
Grade: N Phone Number: 828.421.7229
Sianbq OfWars Title: Manager
Has the ORC changed since the previous NDAR-27 ❑ ym 0 No
Phone Number. [phone] Pa m t Pte.: 05131/2018
Z(. ` 12/1/16
C�`4 ��— 12/1/16
SlgnaWre Date
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Wil Original and Two Coplea to:
Division of Water OwNgr
Information Procan eing Unit
1817 Mall Service Canter
Raleigh, North Carolina 27888-1617